Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301054952 | MI |
NPI | 1164434833 |
---|---|
Provider Name | Dr. Kalyani S Yellayi |
First Address | Detroit, MI 48201-1916 |
Second Address | Detroit, MI 48201-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |